Danielle M. Montgomery
Hanover,MD
Summary
Strategic Director known for high productivity and efficient task completion. Specialize in operational strategy, team leadership, and financial oversight. Excel in communication, problem-solving, and adaptability, ensuring effective team collaboration and project success.
Overview
16
16
years of professional experience
Work History
Director, Care Management
Holy Cross Hospital
12.2020 - Current
- Developed high-performing teams by providing mentorship, guidance, and opportunities for professional growth.
- Enhanced team collaboration through regular communication, goal setting, and performance evaluations.
- Established a culture of continuous improvement by fostering open communication channels and empowering employees to voice their ideas.
- Works collaboratively with outside agencies, managed care organizations and other entities to resolve utilization questions and ensure appropriate hospital payment for services rendered.
- Develops and oversees systems that provide for effective review (concurrent and retrospective) of appropriateness of hospital care and status designation (inpatient vs outpatient)
Manager, Care Management and Utilization Review
Holy Cross Hospital
09.2018 - 12.2020
- Responsible and accountable for the operational management, leadership, professional development and quality assessment and improvement activities of the department, particularly the Care Managers.
- Manages the activities of hospital staff in inpatient care coordination and utilization review. Oversees interactions of staff with outside activities and agencies on regulations affecting patient status and insurance.
- Collaborates and maintains positive working relationships with physicians, physician advisor and external review organizations to ensure quality outcomes, patient throughput, and appropriate resource utilization while supporting the organizations mission.
- Collaborates with the denials prevention and management staff to ensure a low medical necessity denial rate.
- Implemented the use of Milliman Care Guidelines (MCG) to decrease the denial rate with payers who utilize the program.
Lead Case Manager
Holy Cross Hospital
11.2016 - 09.2018
- Provided leadership and direction in the ongoing development of appropriate systems, processes, and practices to support regulatory compliance.
- Enhanced client satisfaction by efficiently managing caseloads and providing personalized support.
- Coordinated services for clients across multiple agencies, ensuring seamless provision of necessary supports.
- Conducted thorough assessments to determine the most appropriate resources and services for each client.
- Maintained strong relationships with clients, resulting in a high rate of successful case outcomes.
- Monitored quality audit processes and supported the implementation of continuous quality improvement policies and procedures.
Case Manager
Holy Cross Hospital
11.2015 - 11.2016
- Maintained accurate documentation on all cases, ensuring compliance with regulations and confidentiality requirements.
- Conducted thorough assessments of clients situations, identifying issues, goals, and necessary interventions.
- Monitored ongoing cases closely, adjusting case management strategies as needed based on evolving circumstances or new information.
- Educated clients on available programs, benefits, and services, empowering them to make informed decisions about their care needs.
Supervisor, Telephone Triage
Rady Children's Hospital
10.2011 - 01.2015
- Oversaw daily operations of the department, ensuring smooth workflow and timely completion of tasks.
- Applied strong leadership talents and problem-solving skills to maintain team efficiency and organize workflows.
- Handled customer complaints, resolved issues, and adjusted policies to meet changing needs.
- Monitored workflow to improve employee time management and increase productivity.
- Responsible for hiring, training, coaching, evaluation and performance management of team members. Ensures optimal staffing of team, in accordance with budgeted positions, productivity, and patient care demands.
- Maintained required service levels by monitoring calls and provided immediate feedback to personnel to enhance call quality.
- Advocated for patients and Telephone Triage operations through direct communication with medical staff, referral sources and other disciplines.
- Participated in the development of a fiscally-sound annual budget and actively participated in analysis of monthly fiscal and productivity reports.
Registered Nurse, Emergency Department
Rady Children's Hospital
02.2008 - 10.2011
- Demonstrated strong clinical reasoning skills when assessing patients conditions, initiating appropriate interventions, and escalating concerns to physicians as needed.
- Collaborated with physicians to quickly assess patients and deliver appropriate treatment while managing rapidly changing conditions.
- Improved patient outcomes by consistently providing high-quality emergency care and implementing evidence-based nursing practices.
- Administered medications via oral, IV, and intramuscular injections and monitored responses.
Education
Master of Science - Nursing Leadership in Health Care System
Grand Canyon University
Phoenix, AZ04.2017
MBA - Business Administration
Grand Canyon University
Phoenix, AZ04.2017
Bachelor of Science - Nursing
Coppin State University
Baltimore, MD05.2007
Skills
- Business Development
- Operations Management
- Project Management
- Staff Development
- Business Planning
- Budget Control
- Strategic Planning
- Effective Leadership
- Process Improvement Initiatives
- Financial Reporting
- Legal and Regulatory Compliance
Timeline
Director, Care Management
Holy Cross Hospital
12.2020 - Current
Manager, Care Management and Utilization Review
Holy Cross Hospital
09.2018 - 12.2020
Lead Case Manager
Holy Cross Hospital
11.2016 - 09.2018
Case Manager
Holy Cross Hospital
11.2015 - 11.2016
Supervisor, Telephone Triage
Rady Children's Hospital
10.2011 - 01.2015
Registered Nurse, Emergency Department
Rady Children's Hospital
02.2008 - 10.2011
Master of Science - Nursing Leadership in Health Care System
Grand Canyon University
MBA - Business Administration
Grand Canyon University
Bachelor of Science - Nursing
Coppin State University